With greater than one million joint replacement procedures performed annually, joint arthroplasty is one of the most common elective surgical procedures performed in the United States. Despite its high success rate with respect to subject satisfaction and pain reduction, joint arthroplasty accounts for nearly $31 billion in hospital charges for the procedure alone. Moreover, post-operative physical therapy (PT) accounts for an additional 10% or roughly $3.1 billion annually. Assessing the recovery of a replaced joint postoperatively requires subjects to return to the hospital semi-regularly over 12 postoperative months for singular joint range of motion (ROM) measurements. This is inconvenient, costly, and has limited scope clinically.
In addition to the above, the high cost of post-operative physical therapy (PT) is in part due to a ‘one-size-fits-all’ implementation for recovery. Specifically, subjects are sent through the same quantity and rigor of physical therapy regardless of other factors following a joint replacement procedure. This type of implementation results in successful postoperative rehabilitation for the vast majority of subjects. Unfortunately, it forces some subjects to participate in PT who would otherwise recover well without any post-operative intervention. This is a gross misuse of a time and money (i.e. personal patient dollars and healthcare system dollars) for patients, physical therapists, and physicians. A second source of the high costs associated with postoperative PT is misdiagnosing a subject who needs more aggressive PT. For example, there are some subjects who do not recover as desired, and if these subjects are not identified early enough, the eventual PT intervention may require musculoskeletal manipulations under anesthesia instead of less expensive and less invasive interventions.